„Maternal and Perinatal outcome in meconium-stained amniotic fluid in term vertex presentation’

Abstract

Objective: To study Maternal and Perinatal outcome in meconium-stained amniotic Fluid.

Materials and Methods: This was a cross-sectional study, conducted in 3 different hospitals in Kigali “one tertiary hospital and 2 districts hospital” (University Teaching Hospital of Kigali (CHUK), Muhima district hospital, and kibagabaga district hospital) over a period of 3months (April to June 2021). The total of 490 pregnant women after 37 completed weeks of gestational with a singleton pregnancy with the cephalic presentation were included in the study, for those 245 pregnant women had meconium-stained amniotic Fluid and the remaining 245 pregnant women had clear amniotic Fluid. Recruited participants were followed till 24hours post-delivery. Microsoft excel was used for Data entry and imported in SPSS version 26 for data analysis we considered P<0.05 as Statistical significance. Results: Out of 490 participants, 385(80.6%) were in the age group between 20-30years of age, 348(71%) had spontaneous labor while 142(29%) were induced. The majority deliver by normal vaginal delivery (NVD) 372(76%), while 118(24%) delivered by c/section. We found the mother who used traditional drugs during pregnancy had a high risk of stained amniotic Fluid 27(77.1%) which was statistically significant. We found low APGAR scores less than 7 after 5min in MSAF group 12(85.7%) than in clear fluid 2(14.3%), a high rate of HIE were seen in meconium-stained Fluid compared to clear fluid 14(87.5%), 2(12.5%) respectively. 3 neonate death were seen in meconium-stained amniotic fluid group in 24hours post follow up, respiratory distress syndrome were statistical significance in MSAF 13(81.2%) than in clear fluid 3(18.8%), there were an increases of NICU admissions in MSAF group than in clear fluid 19(76.0%) 6(24%) respectively.

Conclusion: Meconium-stained amniotic Fluid is associated with an increase in the poor neonatal outcome; “birth asphyxia, and neonatal intensive care unit admissions compared to clear amniotic fluid”